Citation Nr: 21075922 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 16-53 055 DATE: December 21, 2021 REMANDED Entitlement to service connection for a back disability is remanded. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) is remanded. Entitlement to service connection for sleep apnea, to include as due to service-connected disease or injury is remanded. Entitlement to service connection for allergic rhinitis is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for tobacco use disorder, to include as due to service-connected disease or injury is remanded. Entitlement to service connection for eczema is remanded. Entitlement to service connection for a headache disability is remanded. Entitlement to service connection for a respiratory disability is remanded. Entitlement to service connection for mixed mentia is remanded. REASONS FOR REMAND The Veteran served in the U. S. Army from September 1980 to September 1983, with additional service in the Reserves. These matters come before the Board of Veterans' Appeals (Board) from August 2015 and May 2018 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a hearing in August 2021. A transcript of that hearing is of record. During the hearing, the VLJ clarified the issues, asked if there was outstanding evidence and held the file open for the submission of evidence. Such actions comply with 38 C.F.R. § 3.103. 1. Entitlement to service connection for a back disability 2. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) 3. Entitlement to service connection for sleep apnea, to include as due to service-connected disease or injury 4. Entitlement to service connection for allergic rhinitis 5. Entitlement to service connection for hypertension 6. Entitlement to service connection for tobacco use disorder, to include as due to service-connected disease or injury 7. Entitlement to service connection for eczema 8. Entitlement to service connection for a headache disability 9. Entitlement to service connection for a respiratory disability 10. Entitlement to service connection for mixed mentia During the Veteran's August 2021 Board hearing, he testified that some of his conditions began in service and some of his conditions began while he was in the Reserves. As an initial matter, the Veteran's service treatment records (STRs) are only partially associated with the claims file. January 2015 correspondence reflects that the AOJ requested the Veteran's records from the National Personnel Records Center and did not receive a complete copy of the STRs. However, the June 2015 rating decision states that the Veteran's STRs and personnel records from September 1980 to August 1987 were reviewed including Reserve records. The Board is unable to view the referenced evidence. Notably, the May 2018 rating decision noted a review of only STRs from 1980 to 1983. Accordingly, an attempt to associate the Veteran's complete service treatment records, to include his treatment records while in the Reserves should be made on remand. A medical examination or medical opinion is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but: (1) contains competent evidence of a current diagnosed disability or persistent or recurrent symptoms of a disability; (2) establishes that an event, injury, or disease occurred in service or certain diseases manifested during an applicable presumptive period for which the claimant qualifies; and (3) indicates that the disability or symptoms may be associated with the established event, injury or disease in service or with another service-connected disability. McClendon v. Nicholson, 20 Vet. App. 79 (2006). During the Veteran's August 2021 Board hearing, he testified that he began experiencing respiratory symptoms, loud snoring, and allergy symptoms while stationed in Germany during active duty. He reported being treated for skin issues while he was in the Reserves. Accordingly, the Board finds that examinations are warranted for the Veteran's claims of entitlement to service connection for a respiratory disorder, allergy rhinitis, sleep apnea, and eczema. The matters are REMANDED for the following action: 1. Obtain the Veteran's complete service treatment records, to include documents pertaining to his service in the Reserves. Document all requests for information as well as all responses in the claims file. 2. Schedule the Veteran for a VA examination for a respiratory disorder. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion below. The examiner is asked to provide a response to whether any of the identified respiratory disabilities are at least as likely as not related to service, including the Veteran's reported in-service treatment for asthma like symptoms. In providing the requested opinion, consider the Veteran's description of his in-service symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? Review of the entire claims file is required. The examiner must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. 3. Schedule the Veteran for a VA examination for an allergy disability. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion below. The examiner is asked to provide a response on whether any of the identified sinus or allergy disabilities are at least as likely as not related to service, including the Veteran's reported in-service treatment for sneezing? In providing the requested opinion, consider the Veteran's description of his in-service symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? Review of the entire claims file is required. The examiner must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. 4. Schedule the Veteran for a VA examination for a skin disability. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion below. The examiner is asked to provide a response on whether any of the identified skin disabilities are at least as likely as not related to service, including the Veteran's reported treatment while in the Reserves for "little groups of bumps" on his skin. In providing the requested opinion, consider the Veteran's description of his in-service symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? Review of the entire claims file is required. The examiner must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. 5. Schedule the Veteran for a VA examination for his sleep apnea. The examiner must review the claims file. The examiner is asked to provide a response to the following: (a.) Is sleep apnea at least as likely as not related to service, including the Veteran's reported in-service snoring? In providing the requested opinion, consider the Veteran's description of his in-service symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? If the AOJ determines that the Veteran is entitled to service connection for an allergy or respiratory disability, the examiner is asked to provide an opinion on: (b.) whether sleep apnea is at least as likely as not proximately due to a service-connected disability? (c.) whether sleep apnea is at least as likely as not aggravated, i.e., worsened beyond its natural progression, by a service-connected disability. Review of the entire claims file is required. The examiner must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. 6. After completing the development requested above, determine whether the evidence indicates that additional examinations are warranted, as well as any other development deemed necessary, then readjudicate the Veteran's claim. If any of the benefits sought are not granted in full, the AOJ should furnish the Veteran and his representative with an SSOC and afford an opportunity to respond. The claims file should then be returned to the Board for further appellate review. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Fitzgerald, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.